AccountId: 011433970860
ContactId: 247c4547-cb1a-43f1-8bb4-41e1c0cff995
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 355290 ms
Total Talk Time (AGENT): 157051 ms
Total Talk Time (CUSTOMER): 115481 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/247c4547-cb1a-43f1-8bb4-41e1c0cff995_20250319T18:20_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi. Uh, hi, [PII]. My name is, uh, [PII]. I'm calling from the Minimme Distribution Corporation for the benefit check of a patient.
[AGENT][POSITIVE] It would be my pleasure to assist you with those benefits. Do you mind spelling your name for documentation?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And [PII], what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, uh, 02478779.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] and the date of birth, [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] As of right now, I am showing this policy is active. The effective date is [PII]. Now this does have a future term date of [PII].
[CUSTOMER][NEUTRAL] Uh OK. Uh, uh, so can I get the deductible co-insurance and co-pay and out of pocket pocket for the patient for the DME services diabetics.
[AGENT][NEUTRAL] All right. So with this policy, there is no deductible, co-pay or co-insurance.
[AGENT][NEUTRAL] We are a secondary policy and we pay toward the deductible co-pay or co-insurance of the primary insurance policy.
[AGENT][NEUTRAL] And for DME that is a covered benefit.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that benefit amount is $300 per calendar day.
[AGENT][NEUTRAL] And that is what we can pay for the deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] So is that
[CUSTOMER][NEUTRAL] So is it a deductible or copay you're saying the amount?
[AGENT][NEUTRAL] It's just a benefit amount that we can pay toward the deductible co-pay or coinsurance of the primary insurance.
[CUSTOMER][NEUTRAL] How much is the amount? May I know?
[AGENT][NEUTRAL] We can pay up to $300 per calendar day.
[CUSTOMER][NEUTRAL] OK, give me a second.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So there is no deductible, coinsurance, uh, co-pay, and, uh, out of pocket on this, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. So, uh, does it cover DME services?
[AGENT][NEUTRAL] It does up to $300 per calendar day and again that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] It only covers up to the $300. That's it, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] So I have some DME, I mean DME diabetic quotes. Uh, can you just tell me those are covered or not?
[AGENT][NEUTRAL] Well, I can tell you what it does cover. Um, it has to meet the definition of DME which can that definition is that it can stand repeated use.
[AGENT][NEGATIVE] It is not disposable, so any DME that is disposable would not be covered.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And it is covered under the major medical plan.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] It would have to be covered by the major medical for us to be able to provide benefits also.
[CUSTOMER][NEUTRAL] OK. OK. Major medical plan should be covered fully, right?
[AGENT][NEUTRAL] That's right. So if the primary insurance covers it and it does meet the definition, and it's not a disposable piece of DME, it could be considered for benefits under the APL policy.
[CUSTOMER][NEUTRAL] OK, OK, thank you for that information. May I know your name, please?
[AGENT][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] First initial last name, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] OK, so the call references, your name and today's seat.
[AGENT][POSITIVE] Yes, ma'am. That's correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Uh, OK, thank you for that information. Have a great day. Bye for now.
[AGENT][POSITIVE] It's been my pleasure to assist you with those benefits. [PII]. Thank you for calling APL and have a wonderful day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye-bye.